Push and Pull Factors of Emigration among Physicians in Nigeria

Abstract

Physician emigration is escalating in developing countries. In Nigeria, this massive brain drain has gained the popular moniker ‘Japa syndrome’. This survey used a cross-sectional design to determined the factors causing physicians’ brain-drain from Nigeria. A convenience and snowball sampling were used, and 295/400 attendees of a cardiovascular symposium responded to comprehensive self-administered questionnaires (73.7% response rate). Most participants (79.4%) were aged 20-39 years (Mean 35 years SD ±10.17); female (58.6%); married (58.4%) and a family size below six (73.6%). About 85.8% were employed, and 55.9% worked in private establishments. The top three attractive destinations were UK (50.5%), Canada (43.3%), and USA (37.9%). The most frequent push factors found were low remuneration (71.2%), insecurity (62.7%), and difficult working environments (55.9%). Postgraduate-training frustrations (38.6%), and limited educational opportunities for oneself (37.6%), children (26.4%), or spouse (19.7%) were the least. High earning potential (76.6%), career growth opportunities (70.8%), and high-level equipment/technology (54.9%) were the most frequent pull factors. This practice threatens Nigeria's health system and should be addressed multi-sectorally. To reverse this ugly trend, we have to boost physicians’ remuneration, improve work environments and security. Providing innovative education and digital technology would also promote physicians’ retention.